ERCP & Cholangioscopy (Workgroup Leader: Rungsun Rerknimitr)
- Clinical research on agents and technique to reduce post ERCP related complications.
- Novel techniques and devices to manage malignant hilar obstruction
- Diagnostic role of cholangioscopy to confirm malignancy and to diagnose indeterminate biliary strictures including AI application
- Therapeutic role of cholangioscopy and its devices in benign and malignant biliary tract diseases
- The balance between and EUS and ERCP interface for biliary drainage
- New designs for biliary self-expandable metallic and biodegradable stents
- ERCP training curriculum and learning curve; basic and advance
- Duodenoscope reprocessing and its new design to reduce the risk of concerned contamination
|
Hemostasis (Workgroup Leader: Rapat Pittayanon)
Recent activities of the Hemostasis group:
The Asia Pacific Group is probably the most active in Clinical research on endoscopic hemostasis. A publication will appear soon on a multicenter trial that compares the use of a hemostatic powder TC-325 to standard treatment on acute non variceal upper gastrointestinal bleeding. Results to the study were presented at a presidential plenary session to the DDW 2020. (ClinicalTrials.gov Identifier: NCT02534571). A similar study is ongoing evaluating the use of TC-325 in bleeding upper GI cancers. The RCT is led is Professor Pittayanon from Chulalongkorn University Hospital and joined by the Prince of Wales Hospital, Hong Kong and McGill University, Canada. (ClinicalTrials.gov Identifier: NCT03855904).
Another device being evaluated by the Asia Pacific Group is the over-the-scope-clip (OTSC). Professor James Lau is drafting a manuscript over a completed RCT to compare OTSC as a primary treatment, and current standards in nonvariceal AUGIB. (ClinicalTrials.gov Identifier: NCT03216395). The RCT shows significant superiority of OTSC over existing treatment methods. Participating centres include Beijing Friendship Hospital, Suzhou University Hospital and other centres from China and Footscray Hospital from Melbourne, Australia.
The role of second look endoscopy after endoscopic control in the management of AUGIB has been a subject of interest. There have been many RCTs to show that routine second look endoscopy is probably not indicated. Our Asia Pacific Group derived a risk score to predict those at high risk of recurrent bleeding after endoscopic hemostasis. Then the group tested the hypothesis that second look endoscopy in these high risk patients could pre-empt bleeding. The results of this trial is being reported in a Journal soon. (ClinicalTrials.gov Identifier: NCT02352155)
|
Upper GI Imaging (Workgroup Leader: Philip Chiu)
For UGI imaging, future research and initiatives should focus on
- Clinical research on novel technologies for Image Enhanced Endoscopy including role of TXI / NBI for early detection and characterization of early UGI neoplasia
- Application of AI in OGD
- Role of Endocytoscopy for diagnosis and characterization of early UGI neoplasia
- Clinical research on novel IEE in clinical diagnosis of benign UGI diseases
|
Lower GI Imaging (Workgroup Leader: Yasushi Sano)
Endoscopic diagnosis that incorporates new technology, eg. EVIS X1/ TXI / EDOF / AI, in addition to the existing technology
|
Upper GI Tissue Resection (Workgroup Leader: Noriya Uedo)
Example of unanswered questions in Upper GI Tissue Resection:
- What is the correct surveillance strategy for atrophic gastritis and metaplastic gastritis?
- What is the correct surveillance strategy for Barrett’s esophagus?
- When can anticoagulant medication be restarted following gastrointestinal bleeding?
- What is the role of advanced imaging in dysplasia detection in Barrett’s esophagus, squamous cancer detection in high risk patients or intestinal metaplasia in the stomach?
- Can training modules improve image interpretation, lesion recognition, or advanced endoscopic resection skill for endoscopists?
|
Lower GI Tissue Resection (Workgroup Leader: Han-mo Chiu)
Example of unsolved questions in Lower GI Tissue Resection:
- Long term outcomes of T1 cancer after endoscopic resection
- Standardization of post resection surveillance
- Standardization of pathological evaluation of T1 cancer
- Will new technology change the management of T1 cancer? TXI, RDI, endocytoscopy etc.
|